A method of making a ready-to-use catheter assembly is provided, which can be immediately used by a patient. The ready-to-use catheter assembly ensures that the catheter does not suffer from a loss of quality during its shelf life and a wetting medium are provided. The method comprises: placing a catheter with an inactivated hydrophilic outer surface at least along its insertable length and a wetting medium in a catheter package; treating the catheter package with the catheter and the wetting medium with electro-magnetic and/or particle radiation while at least initially the hydrophilic outer surface at least along the insertable length of the catheter remains inactivated; and activating the hydrophilic outer surface at least along the insertable length of the catheter with the wetting medium during and/or after the radiation treatment and wherein the wetting medium decreases in viscosity when submitted to electro-magnetic and/or particle radiation.
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1. A method of making a ready-to-use catheter assembly comprising the following steps:
placing a catheter with an inactivated hydrophilic outer surface at least along its insertable length and a wetting medium in a catheter package, wherein the wetting medium is in a first state a gel comprising at least one polymer, and sealing the catheter package containing the catheter and wetting medium inside said catheter package,
after sealing the catheter package, sterilizing the catheter assembly inside said sealed catheter package by treating the catheter package with the catheter and the wetting medium as said gel in said first state with electro-magnetic and/or particle radiation while at least initially the hydrophilic outer surface at least along the insertable length of the catheter remains substantially inactivated, wherein the wetting medium decreases in viscosity such that the wetting medium transforms from the first state as said gel to a second state as a liquid when submitted to electro-magnetic and/or particle radiation,
activating the hydrophilic outer surface at least along the insertable length of the catheter with the wetting medium in said second state after treating the catheter package with the radiation,
wherein the gel has a viscosity greater than 7000 cp before the sterilizing of the catheter assembly by treating the catheter package with said radiation, and wherein the viscosity of the wetting medium decreases by at least 80% when submitted to said electro-magnetic and/or particle radiation.
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This application claims priority to foreign European patent application No. EP 16001196.1, filed on May 25, 2016, the disclosure of which is incorporated by reference in its entirety.
The present patent application refers to a method of making a ready-to-use catheter assembly, a catheter assembly for use in the method, a ready-to-use catheter assembly and the use of a wetting medium in the method.
Such ready-to-use catheter assemblies are usually used for intermittent catheterization by patients who are unable to empty their bladder naturally. The bladder is then emptied in regular intervals by the patients themselves using a urinary catheter. Urinary catheters are usually provided with a surface treatment using a lubricant to reduce friction in order to allow for an easier and less traumatic insertion into the urethra. Currently, there are two major categories of catheters having lubricated surfaces, namely, gel-coated catheters and hydrophilic coated catheters.
Gel-coated catheters are made easier to insert by application of a water-based gel to the catheter surface. Typically, this gel is supplied with the packaged catheters and a system is provided with the packaged catheters to apply the gel to the surface of the catheters. The gel can either be put onto the catheter surface just before or during the packaging operation or the gel is applied to the surface of the catheter as the catheter is inserted by the patient.
In a hydrophilic coated catheter, the catheter is provided with a hydrophilic coating which is adhered to the outer surface of the catheter. Before insertion of the catheter, the hydrophilic coating is activated by swelling in contact with a hydrating liquid such as water. The catheter surface then has an extremely low coefficient of friction. There exist different systems for hydrophilic coated catheters. It is known that a sterile, individually packed single use catheter is provided in a dry state or condition. The patient opens the package, pours water into the package, waits for approximately thirty seconds and then removes the catheter from the package, which is now ready for insertion. In another version of the hydrophilic coated catheter, the catheter is provided in a package that already contains enough loose liquid water to cause the catheter to be immersed. The user then simply opens the package and removes the catheter which is ready for insertion without the need to add water or to wait. Other products provide the amount of liquid necessary for the immersion of the catheter in a separate compartment of the package or in a sachet arranged in the package. With these products, the user must open a separate compartment of the package or the sachet allowing the liquid to enter the catheter containing chamber for activating the hydrophilic coated surface.
In order to reduce the risk of infections in the urinary tract due to intermittent catheterization, the urinary catheters as well as the wetting media used need to be sterilized. The sterilization of medical devices is usually performed at the time of manufacture using techniques which are well known in the art as for example radiation such as beta radiation or gamma radiation. However, sterilization of a catheter such as an intermittent urinary catheter with a hydrophilic coating is generally regarded as cumbersome if not impossible using conventional techniques. Radiation sterilization of a catheter with a hydrophilic coating has the well known problem that an undesirable chemical modification of said coating occurs, decreasing the quality of the coating which may lead to an increase of the coefficient of friction.
It is therefore known to add one or more buffers, anti-oxidants, or other additives to the wetting fluids to prevent ruining the coating of the catheter during radiation sterilization. Furthermore, it is also known to add hydrophilic polymers to the wetting solution, wetting the hydrophilic coating of the catheter with this polymer solution and to then sterilize the wet or activated hydrophilic coated catheter using radiation.
A further method of preparing a ready-to-use urinary catheter and a catheter assembly for use are disclosed in WO 2014/063711 A1. In this method, a catheter assembly is provided which comprises a first compartment in which a catheter with a hydrophilic coating is placed and a second compartment which comprises the liquid swelling medium. The catheter assembly is then sterilized and after sterilization, the liquid swelling medium is added to the first compartment for wetting and activating the catheters' exterior coating. After that, the second compartment is removed from the catheter assembly.
It is an object of the present patent application to provide alternative solutions for making a ready-to-use urinary catheter and a ready-to-use catheter assembly in which the catheter can be stored for its maximum shelf life without suffering any losses to quality, especially to its hydrophilic coating so that the catheter can be safely inserted into the urethra of the patient without causing discomfort. Furthermore, the method and the catheter assembly itself should be simple and cost effective.
These objects are achieved by a method of making a ready-to-use catheter assembly comprising the following steps:
Placing a catheter with an inactivated hydrophilic outer surface at least along its insertable length and a wetting medium in a catheter package;
Treating the catheter package with the catheter and the wetting medium with electro-magnetic or particle radiation while at least initially the hydrophilic outer surface at least along the insertable length of the catheter remains substantially inactivated;
Activating the hydrophilic outer surface at least along the insertable length of the catheter with the wetting medium during and/or after the radiation treatment; wherein the wetting medium decreases in viscosity when submitted to electro-magnetic and/or particle radiation.
The outer surface of the catheter is the surface of the catheter which potentially comes into contact with human tissue when being inserted into the urethra of a patient. In order to reduce the friction between the catheter and the urethra, this outer surface is hydrophilic at least along its insertable length and therefore very slippery when activated by a wetting medium. In order to obtain the hydrophilic outer surface, the catheter can be coated with a hydrophilic coating or the entire catheter shaft can be made of a hydrophilic material.
The term “insertable length” means the length of the catheter shaft which comes into contact with the human tissue when the catheter is inserted into the urethra of a patient. Due to the many different anatomical structures, it is not possible to define an exact length of the insertable length. Typically, the insertable length of catheters used by male patients lies in a range from approximately 30-40 cm and for female users in a range of approximately 10-20 cm.
The catheter package can be made of a material with low moisture transmission. This means that the package is made of a material that keeps at least an amount of wetting medium inside the catheter package that is large enough to keep the hydrophilic outer surface of the catheter in the activated state for the shelf life of the catheter assembly. Typically, the shelf life of a catheter assembly lies in a range from thirty six months to five years. Examples for a material with low moisture transmission which can be used for the catheter package are composite or multi-laminated materials consisting of aluminum foil, LDPE, MDPE, HDPE, LLDPE or blends of the afore, PP, polyester based polymers (PET), of siloxane coatings. However, it is also possible to provide other methods for keeping the hydrophilic outer surface at least along the insertable length of the catheter in the activated state for the shelf life of the catheter assembly.
Before the treatment with electro-magnetic and/or particle radiation (the radiation treatment), the wetting medium has a high viscosity. Due to the high viscosity, the wetting medium stays in the catheter package at the place where it has been inserted and does not tend to flow towards the catheter. Therefore, the risk for an accidental wetting of the outer surface of the catheter and therefore the risk of activating the hydrophilic material before the radiation treatment is very low. When the catheter assembly with the catheter and the wetting medium is submitted to energy during the radiation treatment the viscosity of the wetting medium decreases. The wetting medium thus comes in a low viscosity state and can easily be brought into contact with the hydrophilic outer surface of the catheter. This can be done by tilting or turning the catheter package around a specific angle, as for example an angle of approximately 90° or 180°. The wetting medium can be any liquid which reduces its viscosity when external conditions are changed. Examples for such liquids are viscoelastic fluids, Bingham fluids, pseudoplastic fluids, dilatant fluids or Newtonian fluids. Furthermore, the wetting medium can be a gel. It is also possible to use a wetting medium which is initially a solid and changes its state of matter during the radiation treatment from the solid state to the liquid state.
In a preferred variant of the method, the electromagnetic and/or particle radiation treatment is a sterilizing step for sterilizing the catheter assembly with the catheter and the wetting medium placed in the catheter package. In this case, no additional production step is necessary.
Preferably, the viscosity of the wetting medium decreases by at least 80%, more preferably at least 90%, when submitted to electro-magnetic and/or particle radiation. In this way, it can be ensured that the wetting medium has a sufficiently low viscosity after the radiation treatment so that an easy activation of the hydrophilic outer surface of the catheter is possible.
In a variant of the method, the wetting medium is a gel comprising at least one polymer. In this context, the term “gel” refers to gels, hydrogels, high viscous aqueous solutions which contain a polymer or a thixotropic agent. Tests have shown that such gels degrade when submitted to radiation sterilization and transform into the desired aqueous fluid solution. This aqueous fluid solution allows easy activation of the hydrophilic outer surface of the catheter.
Preferably, the gel has a viscosity of at least 7000 cP, preferably at least 25000 cP, before the radiation treatment. In this case, the viscosity of the wetting medium before the radiation treatment is high enough to enable an easy separation between the wetting medium and the hydrophilic outer surface at least along the insertable length of the catheter. During the radiation treatment, the wetting medium degrades sufficiently, so that it can be easily brought into contact with the hydrophilic outer surface at least along the insertable length of the catheter for activating this surface due to its fluid nature.
In a further embodiment, the polymer is organic or synthetic carbohydrate or a liquid based polymer. Such a gel combines the desired high viscosity before the radiation treatment and the requested liquid properties for activating the hydrophilic outer surface at least along the insertable length of the catheter after being submitted to electro-magnetic and/or particle radiation.
In a further variant of the method, the radiation used for the radiation treatment is gamma radiation, x-ray, e-beam or UV. This leads to a sterile state of the whole catheter assembly and also ensures that sufficient energy is delivered to the wetting medium so that the wetting medium transforms into the aqueous solution during the radiation treatment.
Tests have shown that the best results can be achieved when the energy dose of the radiation is in a range of 1 to 50 kGy, preferably 15 to 45 kGy, more preferably 25 to 45 kGy. With such an energy dose, no damage to the catheter is incurred and the wetting medium degrades and turns into the aqueous liquid.
In still another variant, the catheter package used in the method can comprise an open channel diversion for separating the catheter with the hydrophilic outer surface at least along its insertable length and the wetting medium from each other before and during the radiation treatment. For example, the catheter package can be provided with at least one welding seam which forms a back taper in the package and in which the wetting medium is arranged. In a variant, the catheter with the hydrophilic outer surface at least along its insertable length and the wetting medium can be separated by a physical barrier. The open channel diversion and the physical barrier ensure that the hydrophilic outer surface at least along the insertable length of the catheter and the wetting medium do not come into contact before and during the radiation treatment which could lead to a degradation of the hydrophilic outer surface.
It can be further provided that the catheter is surrounded by a sleeve. Due to this sleeve, the patient can easily grip and insert the activated slippery catheter.
In a further variant of the method, it can be provided that the wetting medium is partially a gel and partially an aqueous solution. The gel forms a plug which holds the aqueous solution in a cavity so that it does not come into contact with the hydrophilic outer surface of the catheter before and during the radiation treatment. During the radiation treatment, the gel experiences a decrease in viscosity so that the activation of the hydrophilic outer surface at least along its insertable length of the catheter can be easily performed after the radiation treatment. In this case, a viscosity decrease of just 10% would be sufficient, because the plug only needs to dislocate to let the aqueous solution pass.
It is a further object of the present invention to provide a catheter assembly for use in a method as described above. The catheter assembly comprises a catheter package, a catheter with an inactived hydrophilic outer surface at least along its insertable length arranged in the catheter package, and a wetting medium arranged in the catheter package, whereby the wetting medium decreases in viscosity when submitted to electro-magnetic and/or particle radiation. The catheter assembly therefore allows an easy and secure separation between at least the insertable length of the hydrophilic outer surface of the catheter and the wetting medium before and at least initially during the treatment with electro-magnetic and/or particle radiation, and an easy activation of the hydrophilic outer surface of the catheter during and/or after the radiation treatment when the wetting medium has experienced the decrease in viscosity.
In a preferred embodiment, the wetting medium is at least partially a gel with a viscosity of at least 7000 cP, preferably at least 25000 cP, before the radiation treatment. Due to the high viscosity, the gel is immobilized in the catheter package and does not come into contact with the hydrophilic outer surface at least along the insertable length of the catheter before and at least initially during the radiation treatment.
Additionally, it can be provided that the catheter package comprises an open channel diversion for separating the catheter with the hydrophilic outer surface at least along its insertable length and the wetting medium from each other before and during the radiation treatment. The open channel diversion is an additional safeguard to avoid contact between the wetting medium and the hydrophilic outer surface at least along its insertable length of the catheter before and at least initially during the radiation treatment which could damage the hydrophilic outer surface of the catheter and could cause problems when inserting the catheter. Due to the open channel structure, a contact between the outer surface of the catheter and the wetting medium is easily possible after the radiation treatment when the wetting medium has experienced the decrease in viscosity.
It is also possible to provide the catheter package with at least one welding seam which forms a back taper in the package in which the wetting medium is arranged. This is an easy and economic way to provide an open channel diversion structure in the catheter package which can be easily integrated in the production process of the catheter assembly. The back taper retains the wetting medium before and during the radiation treatment. After the radiation treatment, the low viscous wetting medium can easily flow out of the back taper to the catheter to activate the hydrophilic outer surface at least along the insertable length of the catheter.
To ensure a very secure separation between the hydrophilic outer surface at least along the insertable length of the catheter and the wetting medium, it can be provided that the catheter with the hydrophilic outer surface at least along its insertable length and the wetting medium are separated by a physical barrier. Such a barrier can, for example, be a clip or another fastener device.
In still another embodiment, the catheter package comprises a perforated lining which is arranged between the catheter with the hydrophilic outer surface at least along its insertable length and the wetting medium. The high viscosity wetting medium is then held back by the perforated lining during the radiation treatment and can pass through the perforated lining during and/or after the radiation treatment when it has degraded into an aqueous solution with low viscosity. Such a perforated lining can be achieved by welding during the manufacture process and is therefore easy and cost effective. When necessary, external pressure can be applied onto the part of the catheter package behind the perforated lining to squeeze the wetting medium in to the catheter compartment.
In another embodiment, at least a part of the catheter is surrounded by a sleeve. This sleeve can be used as an introduction aid to insert the activated and thus very slippery catheter into the urethra. Furthermore, the sleeve can be arranged around the external end of the catheter before use so that the wetting medium does not come into contact with these parts of the catheter.
Furthermore, it can be provided that the wetting medium is partially an aqueous solution and partially a gel which forms a plug to separate the aqueous solution from the catheter with the hydrophilic outer surface at least along its insertable length. This is another way to ensure that the hydrophilic outer surface of the catheter and the wetting medium are kept separate before and at least initially during the radiation treatment of the catheter assembly to avoid degradation of the hydrophilic parts of the catheter which would cause problems during the use of the catheter assembly.
Furthermore, the catheter assembly can comprise an insertion aid for the catheter which is preferably arranged near the catheter tip. The insertion aid can be a cylindrical part which can be easily gripped by the patient. In this case, the wetting medium is preferably arranged in the insertion aid. After the radiation treatment, the catheter assembly is simply rotated around 180° and the wetting medium then flows out of the introduction aid and along the catheter shaft to activate the hydrophilic outer surface at least along the insertable length of the catheter.
It is a further object of the present invention to provide a ready-to-use catheter assembly which can be directly used by a patient without the need for activation and wherein the low friction properties of the catheter do not degrade during storage so that a complication-free introduction of the catheter into the urethra is guaranteed during its whole shelf life which ranges from approximately thirty six months to five years. This is achieved by a ready-to-use catheter assembly which comprises a catheter package, a catheter with a hydrophilic outer surface at least along its insertable length arranged in the catheter package and a wetting medium which is also arranged in the catheter packing and which is in contact with the hydrophilic outer surface of the catheter so that the hydrophilic outer surface is activated, wherein the wetting medium is a gel comprising at least one polymer and has a viscosity below 1000 cP, preferably below 100 cp.
The ready-to-use catheter assembly therefore comprises a pre-activated catheter which can be directly used by the patient. The patient does not have to perform any activating steps which are often cumbersome to perform by a person with reduced dexterity. Furthermore, due to the fact that the activation has been performed during the manufacturing process, it can be guaranteed that the activation has been performed properly and the catheter has a sufficiently slippery surface along the complete insertable length thereof. Therefore, no problems due to high friction occur during the use of the catheter. The desired low viscosity of the wetting medium is achieved by submitting the wetting medium to a radiation treatment where the wetting medium degrades to an aqueous solution.
It is still a further object of the present invention to provide an easy and secure method to activate a hydrophilic coated catheter. This object is achieved by using a wetting medium for activating the hydrophilic outer surface at least along the insertable length of the catheter whereby the wetting medium experiences a decrease in viscosity when submitted to electro-magnetic and/or particle radiation.
In the following, the invention is described in more detail with the aid of figures.
The wetting medium 4 experiences a decrease in viscosity when submitted to electro-magnetic and/or particle radiation. For example, the wetting medium can be a gel. In the context of the present patent application, the term “gel” refers to gels, hydrogels, and any high viscous aqueous solutions which contain a polymer or a thixotropic agent.
The catheter 3 comprises an inactivated hydrophilic outer surface 5 at least along its insertable length. The catheter 3 and the wetting medium 4 are arranged in the catheter package 2 in such a way that the hydrophilic outer surface 5 remains substantially inactivated. In the present case the wetting medium 4 does not come into contact with at least the hydrophilic outer surface 5 of the catheter 3. As the wetting medium is relatively solid and exhibits little or no viscous flow, it stays at the position in which it has been placed and does not flow in the direction of the hydrophilic outer surface 5 of the catheter 3.
The catheter assembly 1 further comprises a sleeve 6. The sleeve 6 surrounds the catheter 3 and is placed at the external end of the catheter 3 which lies opposite the catheter tip 7. At its end facing away from the catheter 3, the sleeve 6 is folded so that the wetting medium 4 cannot enter the sleeve 6.
The catheter 3 is arranged above the bottom of the catheter package 2 so that the hydrophilic outer surface 5 of the catheter 3 is not in contact with the wetting medium 4. The catheter package 2 comprises a perforated lining 21 which forms a compartment 20 for the wetting medium 4. The perforated lining 21 can be made by welding separate points of the catheter package 2.
A fifth embodiment of a catheter assembly 23 is shown in
A further embodiment of a catheter assembly 42 is shown in
In the embodiments 1 to 9 as described above the wetting medium 4 can be a gel which experiences a non-reversible decrease in viscosity when energy is brought into the system, for example via electro-magnetic and/or particle radiation. The gel then transforms into an aqueous solution which flows through the catheter package 2 and thus activates the hydrophilic outer surface 5 of the catheter 3. The wetting medium 4 therefore directly activates the hydrophilic outer surface 5 of the catheter 3 at least along its insertable length. It is also possible to use viscoelastic fluids, Bingham fluids, pseudoplastic fluids, dilatant fluids or Newtonian fluids as wetting medium as long as they experience a decrease in viscosity when submitted to external effects. It is also possible that the wetting medium changes its state of matter during the radiation treatment from a solid to a liquid state. In this context, solid state means that the material has a definite shape and volume. Liquid state means that the material has a definite/constant volume and a shape that conforms to the shape of its container.
In the embodiments as shown in
The wetting medium is partly formed of an aqueous solution 32 and partly of a gel-like system 33. The gel 33 is arranged in the channel 36 and thus forms a plug which holds the aqueous solution 32 in the back taper 35. The aqueous solution 32 can thus not exit the back taper 35 and is separated from the hydrophilic outer surface 5 of the catheter 3.
In the following, methods for making the ready-to-use catheter assembly as described above are explained in detail.
The wetting medium 4 reduces viscosity during electro-magnetic and/or particle radiation. In
The method for making a ready-to-use catheter assembly according to the second embodiment for the catheter assembly 10 as shown in
The same method is shown in
In
In all the embodiments as described above, the viscosity of the wetting medium 4 before the radiation treatment with electro-magnetic and/or particle radiation, that is the gel, is at least 7000 cP, preferably at least 25000 cP. During the radiation treatment, when the wetting medium 4 is submitted to electro-magnetic and/or particle radiation, the viscosity of the wetting medium 4 decreases by at least 80%, preferably at least 90%.
In a preferred embodiment for the wetting medium 4, the viscosity of the wetting medium after the treatment with electro-magnetic and/or particle radiation is smaller than 1000 cP, preferably smaller than 100 cP. The viscosity of the wetting medium (gel) was measured using a Brookfield viscometer. The sample was placed below the spindle and the spindle was lowered into the sample to a set point.
The spindle rotates at a specific speed (30 rpm) and the resistance of the gel correlates to the viscosity. The spindle used was LV4, #64. The temperature at the test was 25° C.
In
The methods for making the ready-to-use catheter assembly are described only for a wetting medium which initially is in the form of a gel. As described earlier, the wetting medium can be any liquid which reduces its viscosity when external conditions are changed, for example viscoelastic fluids, Bingham fluids, pseudoplastic fluids, dilatant fluids or Newtonian fluids. It is also possible to use a wetting medium which initially is a solid and which experiences a change of state of matter during the radiation treatment from the solid state to the liquid state.
Kelly, Ronald John, Fitzgerald, Alan, Tierney, Morgan, Scully, David, Ryan, Katy
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